| Kelli Sieczkowski, Pllc | |
|
1930 S Alma School Rd Ste D202 Mesa AZ 85210-3045 | |
| (480) 630-0316 | |
| Not Available |
| Full Name | Kelli Sieczkowski, Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1930 S Alma School Rd Ste D202, Mesa, Arizona |
| Authorized Official Name and Position | Kelli Lynn Sieczkowski (OWNER) |
| Authorized Official Contact | 4806300613 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelli Sieczkowski, Pllc 2469 W Zepher Ave Flagstaff AZ 86001-2543 Ph: (928) 225-9585 | Kelli Sieczkowski, Pllc 1930 S Alma School Rd Ste D202 Mesa AZ 85210-3045 Ph: (480) 630-0316 |
| NPI Number | 1851830582 |
|---|---|
| Provider Enumeration Date | 02/14/2017 |
| Last Update Date | 07/08/2019 |
| Medicare PECOS PAC ID | 2264700954 |
|---|---|
| Medicare Enrollment ID | O20170621002754 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851830582 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LCSW10655 (Arizona) | Primary |
| Provider Name | Kelli L Sieczkowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740459460 PECOS PAC ID: 7012100811 Enrollment ID: I20101026000339 |
| Provider Name | Marjolein S Sieczkowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457850984 PECOS PAC ID: 8729341813 Enrollment ID: I20180425000765 |
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